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To examine differences in physical health conditions among female veterans compared with male veterans and female civilians.
Cohort analysis using data from the UK Biobank, incorporating self-reported and hospital-derived health information.
Veteran status was identified using Standard Occupational Classification codes. The study included female veterans (n=546), male veterans (n=2722) and female civilians (n=66 305).
Physical health conditions were identified through self-report and hospital records. Multivariable logistic regression models estimated associations between veteran status and selected health conditions, adjusting for age, sociodemographic factors, time in service, body mass index and current smoking status.
Compared with female civilians, female veterans had increased odds of chronic obstructive pulmonary disease (adjusted OR (aOR) 1.79, 95% CI 1.04 to 3.08) and lower odds of hypertension (aOR 0.74, 95% CI 0.59 to 0.93), with no significant difference in musculoskeletal conditions or osteoarthritis. Compared with male veterans, female veterans had significantly higher odds of osteoarthritis (aOR 1.61, 95% CI 1.25 to 2.08), migraine (aOR 2.63, 95% CI 1.66 to 4.19) and thyroid disorders (aOR 4.42, 95% CI 2.83 to 6.89).
Female veterans have distinct physical health profiles, including a greater burden of musculoskeletal and respiratory conditions compared with male veterans and female civilians. These findings highlight the need for targeted prevention and clinical interventions for women with a history of military service.
To explore oncology nursing advance care planning practices and understand how to better support nurses in conducting advance care planning with patients and their families.
Qualitative interpretive descriptive methodology.
Semi-structured, individual telephone or Zoom interviews with 19 oncology nurses in a Western province of Canada between May and August 2022. Interviews were audio-recorded, transcribed, de-identified, and analysed using inductive, thematic, and constant comparative techniques.
Oncology nurses highlighted several factors affecting their ability to engage in advance care planning, including (1) uncertainties related to the nursing role in advance care planning, such as how and when a nurse ought to engage; (2) the educational, experiential, and training environment; and (3) structural barriers, such as a lack of time, space, and privacy; models of care that inhibit nurses from developing longitudinal relationships with their patients; and team dynamics that affect advance care planning interdisciplinary collaboration.
To create environments that support oncology nurses to conduct advance care planning, the findings suggest uncertainties be addressed through a clear and cohesive organisational approach to advance care planning and ongoing, integrated educational opportunities. Further, service delivery models may need to be restructured such that nurses have dedicated time and space for nurse-led advance care planning and opportunities to develop trusting relationships with both patients and their interdisciplinary colleagues.
Oncology nurses recognised the value of advance care planning in supporting patient-centred care and shared decision making, yet they reported limited engagement in advance care planning in their practice. To support oncology nurses in conducting advance care planning, healthcare leaders may address (1) advance care planning-related uncertainties and (2) structural barriers that prevent nurses from engaging in advance care planning with patients and their families. Findings may guide modifications to care models, enhancing support for oncology nurses in conducting advance care planning.
We selected and adhered to the Consolidated Criteria for Reporting Qualitative Research (COREQ) as the most applicable guideline.
No patient or public contribution.
The aim of this study was to develop a conceptual understanding of the role of caring for older adults with combined vision and hearing impairment (DSI).
Dual sensory impairment (DSI) impacts both listening and speechreading communication, function and social participation, meaning that older adults often require support and care to ‘age in place’ successfully. Family carers play a key role in supporting older adults with DSI to maintain social and physical health.
This qualitative study uses Charmaz's constructivist grounded theory (GT) methodology. Data were collected between 2017 and 2019 and analysed using constructivist GT methods. Lengthy interviews with eight family carers of older adults living with DSI explored personal histories of DSI, relationships with families, social networks and health care professionals.
This study demonstrates that caring in this context is predominantly social and ‘invisible’. To reduce the social effort of their family member with DSI and to maintain their own self-identity, family carers adopted a ‘conscious caring’ approach. This is conceptualised as an approach to caring that supports family carers to access resources embedded in their social networks by bridging the gap between the dyad and their broader, more diverse social networks.
This study identifies that a reduction in both close and broader social networks limits personal, social and psychosocial resources and impacts the capacity of the dyad to renegotiate their roles, create and maintain their individual and shared social networks and successfully transition to living with DSI.
There is a gap in the literature regarding the impact of sensory impairments on complex communication, health and social care needs of older adults and the role that family carers play. Registered nurses require complex communication skills to support older persons with DSI during health and social care interactions. A better understanding of DSI itself, as well as understanding the key role family carers play in integrating care for their family member, is crucial to delivering person-centred care.
This study addresses a growing social gerontological issue and identifies the role that family carers play in integrating health and social care for their family member with DSI. Better professional recognition of DSI and increased visibility of the challenges of living with DSI could help address barriers to effective communication between service providers, formal care support staff and those with DSI. Integrating family carers into care teams is critical to improving health and social care experiences for both caregiver and care receiver.
This study did not include patient or public involvement in its design, conduct, or reporting.
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